'Weekend effect' not so simple, studies find

A pair of studies published in The Lancet shows the 'weekend effect' on hospital mortality rates and quality of care may not be as simple as previous research has suggested, according to Medscape.

The weekend effect posits that quality of care at hospitals is lower and mortality rates are higher for patients admitted on weekends or overnight when staffing levels are inadequate and hospitals may not be running at 100 percent.

This research comes amid a dispute between the U.K.'s National Health Service and its junior physicians, in which the weekend effect is a hotly contested issue.

Here are the key takeaways from each study.

1. The first study, which examines stroke care outcomes, calls the weekend effect a simplification.

  • Researchers examined more than 74,000 patients with acute stroke admitted to nearly 200 hospitals and measured 30-day, post-admission survival rates.
  • They found quality of care varied across several patterns, noting both daily variations and various day-of-the-week variations, among others.
  • The greatest variation was for door-to-needle time within 60 minutes, or the time between arrival in the emergency room to initiation of treatment.
  • No difference in 30-day survival rates was noted between weekends and weekdays, except among patients admitted overnight on weekdays, who had lower odds of surviving.

2. The second study examines hospital specialist staffing and mortality risk for emergency admissions and finds no correlation.

  • Researchers compared weekday admission mortality risk with a Sunday to Wednesday intensity ratio, which is based on the self-reported number of specialist hours per 10 emergency admissions between 8:00 a.m. and 8:00 p.m.
  • They found significantly fewer specialists were present on Sunday compared to Wednesday.
  • They also found specialists spent 40 percent more time caring for emergency patients on Sunday than those admitted on Wednesday.

Taken together, the studies show other forces may be at work in care variation, perhaps including how sick patients are when they are admitted to the ER.

 

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